US20080319452A1 - Method and system for insertion of a graft - Google Patents
Method and system for insertion of a graft Download PDFInfo
- Publication number
- US20080319452A1 US20080319452A1 US12/142,025 US14202508A US2008319452A1 US 20080319452 A1 US20080319452 A1 US 20080319452A1 US 14202508 A US14202508 A US 14202508A US 2008319452 A1 US2008319452 A1 US 2008319452A1
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- Prior art keywords
- tool
- head
- tubular
- measurement
- longitudinal axis
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
- G01B5/00—Measuring arrangements characterised by the use of mechanical techniques
- G01B5/08—Measuring arrangements characterised by the use of mechanical techniques for measuring diameters
- G01B5/12—Measuring arrangements characterised by the use of mechanical techniques for measuring diameters internal diameters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1103—Approximator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1125—Forceps, specially adapted for performing or assisting anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/9522—Means for mounting a stent or stent-graft onto or into a placement instrument
Definitions
- Some known methods include grasping and bending a vessel in a convenient direction for insertion of a graft. These methods may stretch and damage the vessel.
- Some known methods include gripping the graft, for example, by forceps or tweezers, and the gripping may not be firm enough so that, for example, the graft may slip. Additionally, the direction in which the graft may be held may change because the grip may include only two hubs of contact.
- Holding a graft by regular forceps for example so that the longitudinal axis of the forceps is substantially parallel to the longitudinal axis of the graft, in some cases may compel the user to push the graft into the vessel diagonally, thus stretching the vessel and possibly causing damage to the living tissue.
- FIG. 1A is a schematic illustration of a delivery tool according to embodiments of the present invention.
- FIG. 1B is a schematic cross-sectional illustration of a delivery tool according to embodiments of the present invention.
- FIG. 1C is a schematic three-dimensional illustration of a grip head of a delivery tool according to embodiments of the present invention.
- FIG. 1D is a schematic three-dimensional and partially transparent illustration of a grip head gripping an object according to embodiments of the present invention
- FIG. 2A is a schematic illustration of a measurement tool according to embodiments of the present invention.
- FIGS. 2B and 2C are schematic illustrations of a measurement tool from two different angles according to embodiments of the present invention, wherein FIG. 2C is cross sectional;
- FIGS. 2E and 2F are schematic illustrations of two states of a flexible stripe of a measurement tool during insertion and/or extraction of the measurement tool through a pipe according to embodiments of the present invention
- FIGS. 3A and 3B are schematic illustrations of portions of a measurement tool according to embodiment of the present invention.
- FIG. 3C is a schematic cross-sectional illustration of a portion of a measurement tool according to embodiment of the present invention.
- FIGS. 4C and 4D are schematic three-dimensional illustrations of two positions of an insertion tool according to embodiments of the present invention.
- FIG. 4E is a schematic cross sectional illustration of a grasping tip and stabilizing tips of an insertion tool grasping a tubular fastener according to embodiments of the present invention.
- FIG. 5 is a flow chart describing a method for insertion of a graft according to embodiments of the preset invention.
- Embodiments of the present invention may provide a method for easy and safe insertion of a graft to vessel with minimal potential damage to the living tissue and to the graft.
- a set of tools enabling the method may be also provided.
- FIG. 1A is a schematic illustration of delivery tool 100 according to embodiments of the present invention.
- Delivery tool 100 may be insertable into a body lumen preferably through a trocar or other device or incisions (not shown) commonly used in laparoscopic surgery.
- Delivery tool 100 may include a handhold 150 , a handle 130 , control means 140 , a tube 120 and grip head 110 .
- Delivery tool 100 may be held by handhold 150 and thus, for example, be directed inside the body lumen.
- Grip head 110 may grip a tubular object, for example by adjustment of an external diameter of grip head 110 , at a certain position on the grip head, to an internal diameter of the tubular object until a firm grip is achieved.
- Grip head 110 may include head segments 115 , which may draw near and away from each other, thus, for example, changing the external diameter of grip head 110 .
- Grip head 110 may include adjustment head 105 which may controllably adjust the external diameter of grip head 110 .
- Adjustment head 105 may include varying external diameter and thus, for example, may change the external diameter of grip head 110 by insertion of the suitable portion of adjustment head 105 between head segments 115 .
- Adjustment head 105 may have, for example, a conical shape.
- the external diameter of adjustment head 105 may get larger in a direction from the tool outwards.
- Adjustment head 105 and/or the external diameter of grip head 110 may be controllable by control means 140 .
- control means 140 may cause reduction of the external diameter of grip head 110 , thus, for example, releasing a tubular body from grip by grip head 110 .
- pulling of control means 140 may cause insertion of a portion of adjustment head 105 between head segments 115 , thus, for example, expanding the external diameter of grip head 110 correspondingly to the external diameter of the inserted portion of adjustment head 105 .
- Control means 140 may include, for example, a spring apparatus (not shown).
- control means 140 may expand the external diameter of grip head 110 to its maximum size and/or until it meets an internal diameter of another object to be gripped by grip head 110 .
- the grip of the object may be secured by the constant force of the spring.
- the external diameter of grip head 110 may be changed, for example, reduced.
- reducing of the external diameter of grip head 110 may release the grip and the object may be detached from delivery tool 100 .
- adjustment head 105 may be controlled by control means 140 .
- Control means 140 may control adjustment head 105 through a control shaft 145 .
- adjustment head 105 may include several portions with different external diameters, for example, portions 105 A- 105 D. Each of portions 105 A- 105 D may have a different external diameter. Preferably, the external diameter may get larger as the distance of the portion from control shaft 145 is larger. In the example of FIG.
- portion 105 B may have a greater external diameter than portion 105 A
- portion 105 C may have a greater external diameter than portion 105 B
- portion 105 D may have a greater external diameter than portion 105 C.
- the external diameter of grip head 110 may be changed correspondingly to the external diameter of the portion of adjustment head 105 inserted within grip head 110 , for example, by pushing apart head segments 115 .
- FIG. 1C is a schematic three-dimensional illustration of grip head 110 according to embodiments of the present invention.
- head segments 115 may be pushed apart, thus, for example, expanding the external diameter of grip head 110 .
- the external diameter of grip head 110 may be changed correspondingly to the external diameter of the adjustment head 105 which may be inserted in between head segments 115 .
- FIG. 1D is a schematic three-dimensional and partially transparent illustration of grip head 110 gripping an object 500 according to embodiments of the present invention.
- Grip head 110 may include terraced external diameter, for example in order to match different internal diameters of different objects. Further adjustment of the external diameter of grip head 110 may be achieved for example, by controlling adjustment head 105 as described in detail above with reference to FIGS. 1A-1C .
- the terraced external diameter of grip head 110 and/or the adjustment by adjustment head 105 may enable, for example, firm grip of object 500 on grip head 110 .
- Grip head 110 with or without griped object 500 , may be pulled and/or inserted into tube 120 .
- the insertion and/or extraction of grip head 110 into and/or from tube 120 may be controlled by handle 130 which may move relatively to handhold 150 , along a longitudinal axis of delivery tool 100 .
- grip head 110 with or without griped object 500 , may be stowed within tube 120 during the insertion of delivery tool 100 into a body lumen, and may be pushed out of tube 120 when inside a body lumen.
- the insertion of grip head 110 into tube 120 during the insertion of delivery tool 100 into a body lumen may prevent grip head 110 from being stuck and/or damaged, for example, by a valve installed in the trocar, which may prevent or delay the insertion of delivery tool 100 into a body lumen and/or damage delivery tool 100 and/or the trocar.
- the insertion of grip head 110 into tube 120 during the insertion of delivery tool 100 into a body lumen may also protect object 500 from hitting other objects, such as the valve of the trocar and external tissues like skin, muscles, intestines and others.
- the internal diameter and/or length of tube 120 may be used also for evaluating the size of object 500 and thus, for example, whether it may fit a vessel or other body to which it may be inserted.
- Delivery tool 100 may be in any required size in order to match a range of sizes of grafts or other tubular objects to be griped.
- a measurement may be performed inside a body lumen in order to choose, for example, the right size of a graft and/or the right size of the tools.
- Measurement tool 200 may be insertable into a body lumen preferably through a trocar commonly used in laparoscopic surgery.
- Measurement tool 200 may include a handhold 240 , handle 230 , tube 220 and measurement head 210 .
- Measurement head 210 may be used for diameter measurement, for example of a vessel.
- the suitable size of a graft, optionally attached to a fastener, to be inserted to the vessel may be chosen.
- the suitable size of delivery tool 100 may be chosen.
- measurement tool 200 may include a flexible stripe as will be shown in the following figures.
- measurement tool 200 may also include a ruler on the flexible stripe (shown, for example, in FIG. 2B ).
- the flexible stripe may be controllably inserted into or taken out of tube 220 , for example, by handle 230 .
- Measurement tool 200 may be held by handhold 240 and thus, for example, be directed inside the body lumen.
- Handle 230 may move relatively to handhold 240 , for example, along a longitudinal axis of measurement tool 200 , thus, for example, controlling measurement head 210 and stripe 205 .
- the length of stripe 205 extending out of tube 220 may be controlled by Handle 230 .
- measurement tool 200 may include a flexible stripe 205 .
- Measurement head 210 may be located at the distal end of flexible stripe 205 .
- Flexible stripe 205 may be controllably inserted or taken out of tube 220 , for example, by handle 230 .
- Flexible stripe 205 may enable length measurements inside the body lumen by placing the required portion of stripe 205 against or next to the organ to be measured, for example, by including a ruler 215 .
- a graft with the suitable length may be prepared outside of the body and, inserted into the body lumen and placed in a vessel. Other objects and/or tools may be chosen or prepared based on the length measurement.
- FIG. 2D is a schematic three dimensional illustration of a portion of measurement tool 200 according to embodiment of the present invention.
- Flexible stripe 205 may controllably bend in directions perpendicular to the plane of its face while resisting bending in other directions, for example, according to a force vector provided by a user applied at the distal end of tube 220 .
- the bending may enable measurement in different directions by measurement head 210 and/or ruler 215 .
- the pressure needed at the measurement head 210 for example, in order to bend stripe 205 , may be controlled, thus providing another degree of freedom for the user to operate measurement tool 200 .
- flexible stripe 205 may be controllably inserted or taken out of tube 220 , for example, by handle 230 .
- flexible stripe 205 may be within tube 220 during the insertion or extraction of measurement tool 200 into or from a body lumen, and may be pushed out of tube 220 when inside a body lumen.
- FIGS. 2E and 2F are schematic illustrations of two states of flexible stripe 205 , during insertion or extraction of measurement tool 200 through a pipe 600 according to embodiments of the present invention.
- Pipe 600 may be, for example, a trocar commonly used in laparoscopic procedures.
- Pipe 600 may include a valve 610 which may, for example, limit transition of air and/or other gases or fluids out of the body lumen.
- flexible stripe 205 may be out of tube 220 during insertion or extraction of measurement tool 200 through a pipe 600 .
- valve 610 may prevent or delay the insertion or extraction of measurement tool 200 into or from a body lumen and/or damage measurement tool 200 and/or pipe 600 .
- flexible stripe 205 may be stowed within tube 220 during the insertion or extraction of measurement tool 200 , forming a substantially continuous outer line of tube 220 with measurement head 210 and thus, for example, preventing measurement tool 200 from being stuck, for example, by valve 610 .
- the size of measurement head 210 may be too big in order to be inserted through a trocar such as pipe 600 shown in FIGS. 2E and 2F .
- the trocar diameter may be of about 10-15 mm while the diameter of the vessel may be of about 20-30 mm.
- a measurement tool similar to measurement tool 200 may include an inflatable measurement head instead of measurement head 210 . The measurement tool may be inserted through the trocar in its deflated mode and to be inflated to a required size inside the body after being inserted through the trocar.
- Measurement tool 200 a may include a tube 220 a and a flexible stripe 205 a .
- Tube 220 a and flexible stripe may operate similarly to tube 220 and flexible stripe 205 discussed above with reference to FIGS. 2A-2F .
- Flexible stripe 205 a may include a hollow flexible tube 212 along a longitudinal axis of stripe 205 a .
- flexible stripe 205 a is shown in a side view so that stripe 205 a looks like a narrow line and tube 212 extends beyond the narrow line in both sides.
- Flexible tube 212 may be surrounded by a spring 214 twisted around it, for example, in order to reinforce and/or keep tube 212 from breaking, for example, when flexible stripe 205 a is bending, thus, for example, allowing tube 212 to bend together with flexible stripe 205 a .
- spring 214 may be attached to flexible stripe 205 a , thus, for example, holding tube 212 and flexible stripe 205 a together.
- Measurement tool 200 a may include an inflatable measurement head 210 a .
- inflatable measurement head 210 a When inflatable measurement head 210 a is inflated, as shown in FIG. 3A , it may obtain an inflated target shape and may operate similarly to measurement head 210 as discussed above with reference to FIGS. 2A-2F .
- Measurement head 210 a may be inflatable to a predetermined target size and/or shape. Measurement head 210 a with a specific predetermined inflated size may be selected by a user according to the estimated size of the vessel to be operated.
- the selected head 210 a may be installed on tool 200 a
- Inflatable head 210 a may be made of, for example, polyamide compound, polyvinyl chloride (PVC), cross-linked polyethylene (PE), polyethylene terephthalate (PET), nylon, Nylon elastomers, Polyurethane, and/or other thermoplastic elastomers or a combination thereof.
- Inflatable head 210 a may have a predetermined target size and/or shape. There are various methods for production of inflatable objects with a predetermined target size and/or shape. Some of these methods may include, for example, blow molding.
- Measurement tool 200 a may be inserted through a trocar into a body lumen, for example, a trocar similar to pipe 600 as shown in FIGS. 2E and 2F .
- Inflatable measurement head 210 a may be inserted through the trocar in its deflated mode, as shown in FIG. 3B . This way, for example, a measurement head which has, when inflated, a diameter bigger than the diameter of the available pass through the trocar, may be inserted into the body lumen through the trocar.
- the fluid may be provided to inflatable head 210 a by a pipe passing through measurement tool 200 a and through tube 212 inside the flexible stripe 205 a.
- Measurement tool 200 a may further include a hold 240 a , which may be connected to tube 220 a which is described above with reference to FIGS. 3A and 3B .
- Tube 218 may be threaded through hold 240 a and tube 220 a .
- Tube 218 may be slidable within hold 240 a and tube 220 a .
- Measurement tool 200 a may further include flexible stripe 205 a which is described above with reference to FIGS. 3A and 3B .
- Flexible stripe 205 a may be connected to tube 218 so that, for example, channel 216 may continue through flexible stripe 205 a , for example as tube 212 or inside tube 212 .
- Flexible stripe 205 a may be connected in another side to inflatable head 210 a.
- Inflatable head 210 a may include a channel 260 which may conduct fluid which may arrive, for example, in channel 216 and/or tube 212 , into head 210 a.
- a fluid source for example, an injector
- a fluid source may be connected to port 255 and, for example, provide fluid into void 235 .
- the provided fluid may flow from void 235 to head 210 a , for example, through channel 216 and/or tube 212 .
- the pressure of the fluid inside tool 200 a may be adjusted by spigot top 250 .
- Spigot top 250 may include a piston 252 , which may, for example, be pushed or pulled and/or screw-threaded in or out void 235 .
- the pressure of the fluid inside tool 200 a may be increased, for example, by pushing and/or screw-threading piston 252 into void 235 , thus, for example, decreasing the volume of void 235 and increasing the pressure of the fluid inside tool 200 a .
- the pressure of the fluid inside tool 200 a may be decreased, for example, by pulling and/or screw-threading piston 252 out of void 235 , thus, for example, increasing the volume of void 235 and decreasing the pressure of the fluid inside tool 200 a.
- Flexible stripe 205 a may be controllably inserted or taken out of tube 220 a , for example, by handle 230 a .
- Flexible stripe 205 a may enable length measurements inside the body lumen by placing the required portion of stripe 205 a against or next to the organ to be measured, for example, by including a ruler (similar to ruler 215 of FIGS. 2B-2D ).
- a ruler similar to ruler 215 of FIGS. 2B-2D .
- a graft with the suitable length may be prepared outside of the body and, inserted into the body lumen and placed in a vessel. Other objects and/or tools may be chosen or prepared based on the length measurement.
- flexible stripe 205 a may controllably bend, for example, according to a force vector provided by a user applied at the distal end of tube 220 a .
- the bending may enable measurement in different directions by measurement head 210 a and/or flexible stripe 205 a .
- the pressure needed at the measurement head 210 a for example, in order to bend stripe 205 a , may be controlled, thus providing another degree of freedom for the user to operate measurement tool 200 a.
- Embodiments of the present invention may enable convenient and easy method for insertion of a graft to a vessel, with minimum stretch and damage to the living tissue and/or to the vessel.
- the present invention may also be used for insertion of any suitable tubular object to another tubular cavity.
- FIGS. 4A and 4B are schematic illustrations of an insertion tool 300 according to embodiments of the present invention.
- Insertion tool 300 may include a handhold 340 , a handle 330 , a tube 320 and a grasping head 310 . Insertion tool 300 may be held by handhold 340 and thus, for example, be directed inside the body lumen.
- Grasping head 310 may controllably be pushed or pulled away from tube 320 or to tube 320 , respectively. Handle 330 may control grasping head 310 by moving relatively to handhold 340 . Grasping head 310 may include a grasping tip 315 . Insertion tool 300 may include stabilizing tips 305 arranged parallel to each other and to grasping tip 315 . An object may be grasped between grasping tip 315 and stabilizing tips 305 . As will be described in detail herein below with reference to FIGS. 4C to 4E , grasping tip 315 and stabilizing tips 305 may be used for holding, for example, a fastener head connected to graft to be inserted to vessel.
- FIGS. 4C and 4D are schematic three-dimensional illustrations of two positions of insertion tool 300 according to embodiments of the present invention.
- Grasping head 310 may be pushed away from tube 320 , for example, in order to release a grasped object or before grasping an object.
- Grasping tip 315 may be inserted into the inner cavity of a tubular fastener 510 , next to the inner perimeter of tubular fastener 510 encircling and connected to tubular object 500 .
- tip 315 may be inserted into an inner cavity of a tubular fastener head 510 , next to the inner perimeter of fastener head 510 .
- Grasping head 310 may be pulled towards tube 320 , thus, for example, tightening stabilizing tips 305 against the outer perimeter of tubular fastener 510 .
- insertion tool 300 may include two stabilizing tips 305 , so that together with grasping tip 315 there may be provided three hubs of contact, known to be able to provide tight hold and self adjustment on the grasped object, for grasping tubular fastener 510 .
- the three points of contact may prevent unwanted slips of insertion tool 300 and/or fastener 510 and may provide firm grasping of tubular fastener 510 , which may enable safe steering of fastener 510 inside the body lumen and into a desired location in the vessel.
- a longitudinal axis of insertion tool 300 When grasping tubular fastener 510 , a longitudinal axis of insertion tool 300 may be substantially perpendicular to a longitudinal axis of tubular fastener 510 . This position may provide a convenient approach for inserting tubular object 500 together with tubular fastener 510 into tubular cavity 700 , for example, because longitudinal axis of insertion tool 300 may be substantially perpendicular to a longitudinal axis of tubular cavity 700 . Insertion of tubular object 500 together with tubular fastener 510 into tubular cavity 700 may be achieved, for example, by merely moving insertion tool 300 in the general direction of arrows A.
- FIG. 4E is a schematic cross sectional illustration of grasping tip 315 and stabilizing tips 305 grasping tubular fastener 510 according to embodiments of the present invention.
- two stabilizing tips 305 together with grasping tip 315 may provide three hubs of contact for grasping tubular fastener 510 . Since grasping tip 315 and stabilizing tips 305 have, actually, a longitudinal dimension perpendicular to the plane of FIG. 4E , the grasping provided by grasping tip 315 and stabilizing tips 305 has a an extra stability.
- the three hubs of contact may prevent unwanted slips of insertion tool 300 and may provide firm grasping of tubular fastener 510 and good level of steering of tubular fastener 510 .
- FIG. 5 is a flow chart describing a method for insertion of a graft according to embodiments of the preset invention.
- the method may preferably be carried out by tools similar to the tools described above.
- the method may include gripping tubular object 500 by grip head 110 of delivery tool 100 .
- the method may include grasping tubular object 500 by insertion tool 300 .
- the longitudinal axis of insertion tool 300 may be substantially perpendicular to a longitudinal axis of tubular fastener 510 .
- the method may include detaching tubular object 500 from delivery tool 100 .
- the method may include inserting tubular object 500 into tubular cavity 700 .
- the longitudinal axis of insertion tool 300 may be substantially perpendicular to a longitudinal axis of tubular cavity 700 .
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Abstract
The present invention may provide a method and tools for carrying out a method for insertion of a graft, the method comprising gripping a tubular object by a grip head of a first tool, grasping the object by a second tool, detaching the object from the first tool and inserting the tubular object into a tubular cavity, wherein when inserting, a longitudinal axis of the second tool is substantially perpendicular to a longitudinal axis of the tubular cavity.
Description
- This Application claims the benefit of U.S. Provisional Application Ser. No. 60/929,248 filed Jun. 19, 2007 which is hereby incorporated by reference in its entirety.
- Known methods and tools for insertion of a graft to and placement in a vessel are not specifically designed for the laparoscopic surgery and therefore may be clumsy and inconvenient.
- Some known methods include grasping and bending a vessel in a convenient direction for insertion of a graft. These methods may stretch and damage the vessel.
- Some known methods include gripping the graft, for example, by forceps or tweezers, and the gripping may not be firm enough so that, for example, the graft may slip. Additionally, the direction in which the graft may be held may change because the grip may include only two hubs of contact.
- Holding a graft by regular forceps, for example so that the longitudinal axis of the forceps is substantially parallel to the longitudinal axis of the graft, in some cases may compel the user to push the graft into the vessel diagonally, thus stretching the vessel and possibly causing damage to the living tissue.
- Other tools and methods may be inconvenient and not be suitable for insertion into the body through a trocar or other device or incisions, as usually done in laparoscopic processes. Some tools and methods may be usable only in open surgeries.
- Therefore there is a need for method and tools designed especially for convenient use in implantation of a graft in a vessel, particularly in laparoscopic surgeries.
- The subject matter regarded as the invention is particularly pointed out and distinctly claimed in the concluding portion of the specification. The invention, however, both as to organization and method of operation, together with objects, features, and advantages thereof, may best be understood by reference to the following detailed description when read with the accompanying drawings in which:
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FIG. 1A is a schematic illustration of a delivery tool according to embodiments of the present invention; -
FIG. 1B is a schematic cross-sectional illustration of a delivery tool according to embodiments of the present invention; -
FIG. 1C is a schematic three-dimensional illustration of a grip head of a delivery tool according to embodiments of the present invention; -
FIG. 1D is a schematic three-dimensional and partially transparent illustration of a grip head gripping an object according to embodiments of the present invention; -
FIG. 2A is a schematic illustration of a measurement tool according to embodiments of the present invention; -
FIGS. 2B and 2C are schematic illustrations of a measurement tool from two different angles according to embodiments of the present invention, whereinFIG. 2C is cross sectional; -
FIG. 2D is a schematic three dimensional illustration of a portion of a measurement tool according to embodiment of the present invention; -
FIGS. 2E and 2F are schematic illustrations of two states of a flexible stripe of a measurement tool during insertion and/or extraction of the measurement tool through a pipe according to embodiments of the present invention; -
FIGS. 3A and 3B are schematic illustrations of portions of a measurement tool according to embodiment of the present invention; -
FIG. 3C is a schematic cross-sectional illustration of a portion of a measurement tool according to embodiment of the present invention; -
FIGS. 4A and 4B are schematic illustrations of an insertion tool according to embodiments of the present invention; -
FIGS. 4C and 4D are schematic three-dimensional illustrations of two positions of an insertion tool according to embodiments of the present invention; -
FIG. 4E is a schematic cross sectional illustration of a grasping tip and stabilizing tips of an insertion tool grasping a tubular fastener according to embodiments of the present invention; and -
FIG. 5 is a flow chart describing a method for insertion of a graft according to embodiments of the preset invention. - It will be appreciated that for simplicity and clarity of illustration, elements shown in the figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. Further, where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements.
- In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the invention. However, it will be understood by those skilled in the art that the present invention may be practiced without these specific details. In other instances, well-known methods, procedures, and components have not been described in detail so as not to obscure the present invention.
- Embodiments of the present invention may provide a method for easy and safe insertion of a graft to vessel with minimal potential damage to the living tissue and to the graft. A set of tools enabling the method may be also provided.
- Reference is made to
FIG. 1A , which is a schematic illustration ofdelivery tool 100 according to embodiments of the present invention.Delivery tool 100 may be insertable into a body lumen preferably through a trocar or other device or incisions (not shown) commonly used in laparoscopic surgery.Delivery tool 100 may include ahandhold 150, ahandle 130, control means 140, atube 120 andgrip head 110.Delivery tool 100 may be held byhandhold 150 and thus, for example, be directed inside the body lumen.Grip head 110 may grip a tubular object, for example by adjustment of an external diameter ofgrip head 110, at a certain position on the grip head, to an internal diameter of the tubular object until a firm grip is achieved.Grip head 110 may includehead segments 115, which may draw near and away from each other, thus, for example, changing the external diameter ofgrip head 110.Grip head 110 may includeadjustment head 105 which may controllably adjust the external diameter ofgrip head 110.Adjustment head 105 may include varying external diameter and thus, for example, may change the external diameter ofgrip head 110 by insertion of the suitable portion ofadjustment head 105 betweenhead segments 115.Adjustment head 105 may have, for example, a conical shape. Preferably, the external diameter ofadjustment head 105 may get larger in a direction from the tool outwards.Adjustment head 105 and/or the external diameter ofgrip head 110 may be controllable by control means 140. For example, pushing of control means 140 may cause reduction of the external diameter ofgrip head 110, thus, for example, releasing a tubular body from grip bygrip head 110. Similarly, pulling of control means 140 may cause insertion of a portion ofadjustment head 105 betweenhead segments 115, thus, for example, expanding the external diameter ofgrip head 110 correspondingly to the external diameter of the inserted portion ofadjustment head 105. Control means 140 may include, for example, a spring apparatus (not shown). For example, when released, control means 140 may expand the external diameter ofgrip head 110 to its maximum size and/or until it meets an internal diameter of another object to be gripped bygrip head 110. The grip of the object may be secured by the constant force of the spring. By pushing control means 140, the external diameter ofgrip head 110 may be changed, for example, reduced. When an object is gripped bygrip head 110, reducing of the external diameter ofgrip head 110 may release the grip and the object may be detached fromdelivery tool 100. - Reference is made to
FIG. 1B , which is a schematic cross-sectional illustration ofdelivery tool 100 according to embodiments of the present invention. As described above,adjustment head 105 may be controlled by control means 140. Control means 140 may controladjustment head 105 through acontrol shaft 145. As described above,adjustment head 105 may include several portions with different external diameters, for example,portions 105A-105D. Each ofportions 105A-105D may have a different external diameter. Preferably, the external diameter may get larger as the distance of the portion fromcontrol shaft 145 is larger. In the example ofFIG. 1B ,portion 105B may have a greater external diameter thanportion 105A,portion 105C may have a greater external diameter thanportion 105B andportion 105D may have a greater external diameter thanportion 105C. The external diameter ofgrip head 110 may be changed correspondingly to the external diameter of the portion ofadjustment head 105 inserted withingrip head 110, for example, by pushing aparthead segments 115. - Reference is made to
FIG. 1C , which is a schematic three-dimensional illustration ofgrip head 110 according to embodiments of the present invention. As described above,head segments 115 may be pushed apart, thus, for example, expanding the external diameter ofgrip head 110. Accordingly, the external diameter ofgrip head 110 may be changed correspondingly to the external diameter of theadjustment head 105 which may be inserted in betweenhead segments 115. - Reference is made to
FIG. 1D , which is a schematic three-dimensional and partially transparent illustration ofgrip head 110 gripping anobject 500 according to embodiments of the present invention.Grip head 110 may include terraced external diameter, for example in order to match different internal diameters of different objects. Further adjustment of the external diameter ofgrip head 110 may be achieved for example, by controllingadjustment head 105 as described in detail above with reference toFIGS. 1A-1C . The terraced external diameter ofgrip head 110 and/or the adjustment byadjustment head 105 may enable, for example, firm grip ofobject 500 ongrip head 110.Grip head 110, with or without gripedobject 500, may be pulled and/or inserted intotube 120. The insertion and/or extraction ofgrip head 110 into and/or fromtube 120 may be controlled byhandle 130 which may move relatively to handhold 150, along a longitudinal axis ofdelivery tool 100. For example,grip head 110, with or without gripedobject 500, may be stowed withintube 120 during the insertion ofdelivery tool 100 into a body lumen, and may be pushed out oftube 120 when inside a body lumen. The insertion ofgrip head 110 intotube 120 during the insertion ofdelivery tool 100 into a body lumen may preventgrip head 110 from being stuck and/or damaged, for example, by a valve installed in the trocar, which may prevent or delay the insertion ofdelivery tool 100 into a body lumen and/ordamage delivery tool 100 and/or the trocar. The insertion ofgrip head 110 intotube 120 during the insertion ofdelivery tool 100 into a body lumen may also protectobject 500 from hitting other objects, such as the valve of the trocar and external tissues like skin, muscles, intestines and others. - The internal diameter and/or length of
tube 120, if known, may be used also for evaluating the size ofobject 500 and thus, for example, whether it may fit a vessel or other body to which it may be inserted. -
Delivery tool 100 may be in any required size in order to match a range of sizes of grafts or other tubular objects to be griped. In some embodiments of the present invention, a measurement may be performed inside a body lumen in order to choose, for example, the right size of a graft and/or the right size of the tools. - Reference is now made to
FIG. 2A , which is a schematic illustration ofmeasurement tool 200 according to embodiments of the present invention.Measurement tool 200 may be insertable into a body lumen preferably through a trocar commonly used in laparoscopic surgery.Measurement tool 200 may include ahandhold 240, handle 230,tube 220 andmeasurement head 210.Measurement head 210 may be used for diameter measurement, for example of a vessel. According to this measurement, the suitable size of a graft, optionally attached to a fastener, to be inserted to the vessel may be chosen. Accordingly, the suitable size ofdelivery tool 100 may be chosen. In order to enable measurement in different directions,measurement tool 200 may include a flexible stripe as will be shown in the following figures. In order to measure length,measurement tool 200 may also include a ruler on the flexible stripe (shown, for example, inFIG. 2B ). As will be described in detail herein below, the flexible stripe may be controllably inserted into or taken out oftube 220, for example, byhandle 230.Measurement tool 200 may be held byhandhold 240 and thus, for example, be directed inside the body lumen. Handle 230 may move relatively to handhold 240, for example, along a longitudinal axis ofmeasurement tool 200, thus, for example, controllingmeasurement head 210 andstripe 205. For example, the length ofstripe 205 extending out oftube 220 may be controlled byHandle 230. - Reference is now made to
FIGS. 2B and 2C , which are schematic illustrations ofmeasurement tool 200 from two different angles according to embodiments of the present invention.FIG. 2C is a cross sectional illustration. As mentioned herein above,measurement tool 200 may include aflexible stripe 205.Measurement head 210 may be located at the distal end offlexible stripe 205.Flexible stripe 205 may be controllably inserted or taken out oftube 220, for example, byhandle 230.Flexible stripe 205 may enable length measurements inside the body lumen by placing the required portion ofstripe 205 against or next to the organ to be measured, for example, by including aruler 215. According to the length measurement, for example, a graft with the suitable length may be prepared outside of the body and, inserted into the body lumen and placed in a vessel. Other objects and/or tools may be chosen or prepared based on the length measurement. - Reference is now made to
FIG. 2D , which is a schematic three dimensional illustration of a portion ofmeasurement tool 200 according to embodiment of the present invention.Flexible stripe 205 may controllably bend in directions perpendicular to the plane of its face while resisting bending in other directions, for example, according to a force vector provided by a user applied at the distal end oftube 220. The bending may enable measurement in different directions bymeasurement head 210 and/orruler 215. By choosing the desired length ofstripe 205 extending out oftube 220 the pressure needed at themeasurement head 210, for example, in order to bendstripe 205, may be controlled, thus providing another degree of freedom for the user to operatemeasurement tool 200. - As described above,
flexible stripe 205 may be controllably inserted or taken out oftube 220, for example, byhandle 230. For example,flexible stripe 205 may be withintube 220 during the insertion or extraction ofmeasurement tool 200 into or from a body lumen, and may be pushed out oftube 220 when inside a body lumen. Reference is now made toFIGS. 2E and 2F , which are schematic illustrations of two states offlexible stripe 205, during insertion or extraction ofmeasurement tool 200 through apipe 600 according to embodiments of the present invention.Pipe 600 may be, for example, a trocar commonly used in laparoscopic procedures.Pipe 600 may include avalve 610 which may, for example, limit transition of air and/or other gases or fluids out of the body lumen. As shown inFIG. 2E ,flexible stripe 205 may be out oftube 220 during insertion or extraction ofmeasurement tool 200 through apipe 600. In this case,valve 610 may prevent or delay the insertion or extraction ofmeasurement tool 200 into or from a body lumen and/ordamage measurement tool 200 and/orpipe 600. As shown inFIG. 2F ,flexible stripe 205 may be stowed withintube 220 during the insertion or extraction ofmeasurement tool 200, forming a substantially continuous outer line oftube 220 withmeasurement head 210 and thus, for example, preventingmeasurement tool 200 from being stuck, for example, byvalve 610. - In some cases, the size of
measurement head 210 may be too big in order to be inserted through a trocar such aspipe 600 shown inFIGS. 2E and 2F . For example, the trocar diameter may be of about 10-15 mm while the diameter of the vessel may be of about 20-30 mm. In some embodiments of the present invention, a measurement tool similar tomeasurement tool 200 may include an inflatable measurement head instead ofmeasurement head 210. The measurement tool may be inserted through the trocar in its deflated mode and to be inflated to a required size inside the body after being inserted through the trocar. - Reference is now made to
FIGS. 3A and 3B , each of which is a schematic illustration of a portion of ameasurement tool 200 a according to embodiment of the present invention.Measurement tool 200 a may include atube 220 a and aflexible stripe 205 a.Tube 220 a and flexible stripe may operate similarly totube 220 andflexible stripe 205 discussed above with reference toFIGS. 2A-2F .Flexible stripe 205 a may include a hollowflexible tube 212 along a longitudinal axis ofstripe 205 a. InFIGS. 3A and 3B flexible stripe 205 a is shown in a side view so thatstripe 205 a looks like a narrow line andtube 212 extends beyond the narrow line in both sides.Flexible tube 212 may be surrounded by aspring 214 twisted around it, for example, in order to reinforce and/or keeptube 212 from breaking, for example, whenflexible stripe 205 a is bending, thus, for example, allowingtube 212 to bend together withflexible stripe 205 a. Additionally,spring 214 may be attached toflexible stripe 205 a, thus, for example, holdingtube 212 andflexible stripe 205 a together. -
Measurement tool 200 a may include aninflatable measurement head 210 a. Wheninflatable measurement head 210 a is inflated, as shown inFIG. 3A , it may obtain an inflated target shape and may operate similarly tomeasurement head 210 as discussed above with reference toFIGS. 2A-2F .Measurement head 210 a may be inflatable to a predetermined target size and/or shape.Measurement head 210 a with a specific predetermined inflated size may be selected by a user according to the estimated size of the vessel to be operated. The selectedhead 210 a may be installed ontool 200 aInflatable head 210 a may be made of, for example, polyamide compound, polyvinyl chloride (PVC), cross-linked polyethylene (PE), polyethylene terephthalate (PET), nylon, Nylon elastomers, Polyurethane, and/or other thermoplastic elastomers or a combination thereof.Inflatable head 210 a may have a predetermined target size and/or shape. There are various methods for production of inflatable objects with a predetermined target size and/or shape. Some of these methods may include, for example, blow molding. -
Measurement tool 200 a may be inserted through a trocar into a body lumen, for example, a trocar similar topipe 600 as shown inFIGS. 2E and 2F .Inflatable measurement head 210 a may be inserted through the trocar in its deflated mode, as shown inFIG. 3B . This way, for example, a measurement head which has, when inflated, a diameter bigger than the diameter of the available pass through the trocar, may be inserted into the body lumen through the trocar. -
Inflatable head 210 a, when inflated, may be rigid enough for the measurement purpose, for example, in order to keep its form when inserted into the vessel in order to measure the size of the vessel.Inflatable head 210 a may by inflated by injection of fluid intoinflatable head 210 a, until sufficient pressure is produced insideinflatable head 210 a and/or untilinflatable head 210 a reaches a desired shape. The pressure of the fluid inside theinflatable head 210 a when inflated may be, for example, around 1-2 Atm. - The fluid may be provided to
inflatable head 210 a by a pipe passing throughmeasurement tool 200 a and throughtube 212 inside theflexible stripe 205 a. - Reference is now made to
FIG. 3C , which is a schematic cross-sectional illustration of a portion ofmeasurement tool 200 a according to embodiment of the present invention.Measurement tool 200 a may include ahandle 230 a, which may include aspigot top 250, through which fluid may be provided intomeasurement tool 200 a.Spigot top 250 may include aport 255, to which a fluid source (not shown) may be connected, for example, an injector. Handle 230 a may further include avoid 235.Tool 200 a may further include atube 218 with achannel 216 along its longitudinal axis.Tube 218 may be connected to handle 230 a so that, for example, fluid provided intovoid 235 may flow intochannel 216.Measurement tool 200 a may further include ahold 240 a, which may be connected totube 220 a which is described above with reference toFIGS. 3A and 3B .Tube 218 may be threaded throughhold 240 a andtube 220 a.Tube 218 may be slidable withinhold 240 a andtube 220 a.Measurement tool 200 a may further includeflexible stripe 205 a which is described above with reference toFIGS. 3A and 3B .Flexible stripe 205 a may be connected totube 218 so that, for example,channel 216 may continue throughflexible stripe 205 a, for example astube 212 or insidetube 212.Flexible stripe 205 a may be connected in another side toinflatable head 210 a.Inflatable head 210 a may include achannel 260 which may conduct fluid which may arrive, for example, inchannel 216 and/ortube 212, intohead 210 a. - In order to inflate
head 210 a, a fluid source, for example, an injector, may be connected toport 255 and, for example, provide fluid intovoid 235. The provided fluid may flow fromvoid 235 to head 210 a, for example, throughchannel 216 and/ortube 212. The pressure of the fluid insidetool 200 a may be adjusted byspigot top 250.Spigot top 250 may include apiston 252, which may, for example, be pushed or pulled and/or screw-threaded in or outvoid 235. The pressure of the fluid insidetool 200 a may be increased, for example, by pushing and/or screw-threading piston 252 intovoid 235, thus, for example, decreasing the volume ofvoid 235 and increasing the pressure of the fluid insidetool 200 a. The pressure of the fluid insidetool 200 a may be decreased, for example, by pulling and/or screw-threading piston 252 out ofvoid 235, thus, for example, increasing the volume ofvoid 235 and decreasing the pressure of the fluid insidetool 200 a. -
Flexible stripe 205 a may be controllably inserted or taken out oftube 220 a, for example, byhandle 230 a.Flexible stripe 205 a may enable length measurements inside the body lumen by placing the required portion ofstripe 205 a against or next to the organ to be measured, for example, by including a ruler (similar toruler 215 ofFIGS. 2B-2D ). As described with reference toFIGS. 2A-2F , according to the length measurement, for example, a graft with the suitable length may be prepared outside of the body and, inserted into the body lumen and placed in a vessel. Other objects and/or tools may be chosen or prepared based on the length measurement. - As described in detail above with regard to
flexible stripe 205 ofFIGS. 2A-2F ,flexible stripe 205 a may controllably bend, for example, according to a force vector provided by a user applied at the distal end oftube 220 a. The bending may enable measurement in different directions bymeasurement head 210 a and/orflexible stripe 205 a. By choosing the desired length ofstripe 205 a extending out oftube 220 a the pressure needed at themeasurement head 210 a, for example, in order to bendstripe 205 a, may be controlled, thus providing another degree of freedom for the user to operatemeasurement tool 200 a. - Embodiments of the present invention may enable convenient and easy method for insertion of a graft to a vessel, with minimum stretch and damage to the living tissue and/or to the vessel. Generally, the present invention may also be used for insertion of any suitable tubular object to another tubular cavity. Reference is now made to
FIGS. 4A and 4B , which are schematic illustrations of aninsertion tool 300 according to embodiments of the present invention.Insertion tool 300 may include ahandhold 340, ahandle 330, atube 320 and a graspinghead 310.Insertion tool 300 may be held byhandhold 340 and thus, for example, be directed inside the body lumen.Grasping head 310 may controllably be pushed or pulled away fromtube 320 or totube 320, respectively. Handle 330 may control graspinghead 310 by moving relatively to handhold 340.Grasping head 310 may include agrasping tip 315.Insertion tool 300 may include stabilizingtips 305 arranged parallel to each other and to graspingtip 315. An object may be grasped between graspingtip 315 and stabilizingtips 305. As will be described in detail herein below with reference toFIGS. 4C to 4E , graspingtip 315 and stabilizingtips 305 may be used for holding, for example, a fastener head connected to graft to be inserted to vessel. - Reference is made to
FIGS. 4C and 4D which are schematic three-dimensional illustrations of two positions ofinsertion tool 300 according to embodiments of the present invention.Grasping head 310 may be pushed away fromtube 320, for example, in order to release a grasped object or before grasping an object. Graspingtip 315 may be inserted into the inner cavity of atubular fastener 510, next to the inner perimeter oftubular fastener 510 encircling and connected totubular object 500. For example, if the tubular object is agraft 500 to be inserted tovessel 700,tip 315 may be inserted into an inner cavity of atubular fastener head 510, next to the inner perimeter offastener head 510.Grasping head 310 may be pulled towardstube 320, thus, for example, tightening stabilizingtips 305 against the outer perimeter oftubular fastener 510. Preferably,insertion tool 300 may include two stabilizingtips 305, so that together with graspingtip 315 there may be provided three hubs of contact, known to be able to provide tight hold and self adjustment on the grasped object, for graspingtubular fastener 510. The three points of contact may prevent unwanted slips ofinsertion tool 300 and/orfastener 510 and may provide firm grasping oftubular fastener 510, which may enable safe steering offastener 510 inside the body lumen and into a desired location in the vessel. When graspingtubular fastener 510, a longitudinal axis ofinsertion tool 300 may be substantially perpendicular to a longitudinal axis oftubular fastener 510. This position may provide a convenient approach for insertingtubular object 500 together withtubular fastener 510 intotubular cavity 700, for example, because longitudinal axis ofinsertion tool 300 may be substantially perpendicular to a longitudinal axis oftubular cavity 700. Insertion oftubular object 500 together withtubular fastener 510 intotubular cavity 700 may be achieved, for example, by merely movinginsertion tool 300 in the general direction of arrows A. - Reference is made to
FIG. 4E , which is a schematic cross sectional illustration of graspingtip 315 and stabilizingtips 305 graspingtubular fastener 510 according to embodiments of the present invention. As described above, two stabilizingtips 305 together with graspingtip 315 may provide three hubs of contact for graspingtubular fastener 510. Since graspingtip 315 and stabilizingtips 305 have, actually, a longitudinal dimension perpendicular to the plane ofFIG. 4E , the grasping provided by graspingtip 315 and stabilizingtips 305 has a an extra stability. The three hubs of contact may prevent unwanted slips ofinsertion tool 300 and may provide firm grasping oftubular fastener 510 and good level of steering oftubular fastener 510. - Reference is made to
FIG. 5 , which is a flow chart describing a method for insertion of a graft according to embodiments of the preset invention. The method may preferably be carried out by tools similar to the tools described above. As shown inblock 800, the method may include grippingtubular object 500 bygrip head 110 ofdelivery tool 100. As shown inblock 810, the method may include graspingtubular object 500 byinsertion tool 300. When graspingobject 500, the longitudinal axis ofinsertion tool 300 may be substantially perpendicular to a longitudinal axis oftubular fastener 510. As shown inblock 820, the method may include detachingtubular object 500 fromdelivery tool 100. As shown inblock 830, the method may include insertingtubular object 500 intotubular cavity 700. When insertingtubular object 500 intotubular cavity 700, the longitudinal axis ofinsertion tool 300 may be substantially perpendicular to a longitudinal axis oftubular cavity 700. - While certain features of the invention have been illustrated and described herein, many modifications, substitutions, changes, and equivalents will now occur to those of ordinary skill in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true spirit of the invention.
Claims (47)
1. A method comprising:
gripping a tubular object by a grip head of a first tool;
grasping said object by a second tool, wherein when grasping the object, a longitudinal axis of said second tool is substantially perpendicular to a longitudinal axis of a tubular fastener encircling said tubular object;
detaching said object from the first tool; and
inserting said tubular object into a tubular cavity, wherein when inserting, a longitudinal axis of said second tool is substantially perpendicular to a longitudinal axis of said tubular cavity.
2. A method according to claim 1 , further comprising, before gripping, measuring size of said tubular cavity by a third tool.
3. A method according to claim 2 , wherein said measuring further comprising insertion of a measurement head into said tubular cavity.
4. A method according to claim 2 , wherein said measuring further comprising bending a flexible stripe in a desirable direction.
5. A method according to claim 2 , wherein said measuring is of diameter of said tubular cavity.
6. A method according to claim 2 , wherein said measuring is of at least part of the length of said tubular cavity.
7. A method according to claim 1 , wherein said gripping comprises adjusting external diameter of said grip head to an internal diameter of said tubular object.
8. A method according to claim 7 , wherein said adjusting comprises insertion of an adjustment head having a varying external diameter between segments of said grip head.
9. A method according to claim 1 , wherein said detaching comprises reducing external diameter of said grip head.
10. A method according to claim 9 , wherein said reducing comprises extraction of an adjustment head having a varying external diameter from between segments of said grip head.
11. A method according to claim 1 , further comprising insertion of said grip head into a tube of said first tool at least during passing of said first tool into a body lumen.
12. A method according to claim 2 , further comprising insertion of a flexible stripe of said third tool into a tube of said third tool at least during passing of said third tool into a body lumen.
13. A method according to claim 1 , wherein said grasping include holding said tubular fastener by three hubs of contact.
14. A method according to claim 1 , wherein said gripping and detaching is controlled by operating control means on a handle of said first tool.
15. A method according to claim 1 , wherein said grasping is controlled by moving a handle of said second tool along a longitudinal axis of said second tool.
16. A method according to claim 12 , wherein the length of said flexible stripe extending out of said tube is controlled by moving a handle of said third tool along a longitudinal axis of said third tool.
17. A delivery tool comprising:
a grip head having variable external diameter, for gripping a tubular object by adjusting the external diameter of said grip head to an internal diameter of said tubular object.
18. A delivery tool according to claim 17 , wherein said grip head comprises at least two segments, said segments are for being departed from each other or for being brought closer to each other to modify the external diameter of said grip head.
19. A delivery tool according to claim 18 , further comprising an adjustment head having a varying external diameter for adjusting the external diameter of said grip head by insertion or extraction of said adjustment head between segments of said grip head.
20. A delivery tool according to claim 17 , wherein the external diameter of said grip head is reducible to allow detaching of said tubular body from said grip head.
21. A delivery tool according to claim 17 , further comprising a tube, wherein said grip head is insertible into said tube at least during passing of said delivery tool into a body lumen.
22. A delivery tool according to claim 17 , further comprising control means on a handle of said delivery tool for controlling gripping and detaching of said tubular object.
23. An insertion tool for inserting a tubular object into a tubular cavity, so that when inserting, a longitudinal axis of said insertion tool is substantially perpendicular to a longitudinal axis of said tubular cavity, the insertion tool comprising:
grasping head for grasping a tubular fastener encircling said tubular object, so that when grasping, a longitudinal axis of said insertion tool is substantially perpendicular to a longitudinal axis of said tubular fastener.
24. An insertion tool according to claim 23 , wherein said grasping head is for grasping said tubular fastener by three hubs of contact.
25. An insertion tool according to claim 23 , further comprising a handle for controlling the grasping by moving along a longitudinal axis of said insertion tool.
26. A measurement tool comprising:
measurement head for measuring a diameter of a tubular cavity by insertion of said measurement head into said tubular cavity; and
a flexible stripe bendable in a desirable direction, wherein said measurement head is located at a distal end of said flexible stripe.
27. A measurement tool according to claim 26 , wherein said flexible stripe is for measuring at least part of the length of said tubular cavity.
28. A measurement tool according to claim 27 , wherein said flexible stripe comprises a ruler.
29. A measurement tool according to claim 26 , further comprising a tube, wherein said flexible stripe is insertible into said tube at least during passing of said measurement tool into a body lumen.
30. A measurement tool according to claim 29 , further comprising a handle for controlling the length of said flexible stripe extending out of said tube by moving along a longitudinal axis of said measurement tool.
31. A measurement tool according to claim 26 , wherein the measurement head is inflatable to a predetermined shape and/or size.
32. A measurement tool according to claim 31 , wherein said measurement head is in a deflated state at least during passing of said measurement tool into a body lumen and inflatable at least after insertion of said head into said body lumen.
33. A system comprising:
a delivery tool for gripping a tubular object by a grip head;
an insertion tool for grasping said object so that a longitudinal axis of said insertion tool is substantially perpendicular to a longitudinal axis of a tubular fastener encircling said tubular object, and for inserting said tubular object into a tubular cavity, wherein when inserting, a longitudinal axis of said insertion tool is substantially perpendicular to a longitudinal axis of said tubular cavity.
34. A system according to claim 33 , wherein said grip head has a variable external diameter for gripping said tubular object by adjusting the external diameter of said grip head to an internal diameter of said tubular object.
35. A system according to claim 33 , wherein said insertion tool has a grasping head for grasping said tubular fastener by three hubs of contact.
36. A system according to claim 33 , further comprising a measurement tool for measuring size of said tubular cavity.
37. A system according to claim 36 , wherein said measurement tool comprising:
measurement head for measuring a diameter of said tubular cavity by insertion of said measurement head into said tubular cavity; and
a flexible stripe bendable in a desirable direction, wherein said measurement head is located at a distal end of said flexible stripe.
38. A system according to claim 37 , wherein said flexible stripe is for measuring at least part of the length of said tubular cavity.
39. A system according to claim 37 , wherein said flexible stripe comprises a ruler.
40. A system according to claim 37 , wherein said measurement tool further comprises a tube, wherein said flexible stripe is insertible into said tube at least during passing of said measurement tool into a body lumen.
41. A system according to claim 37 , wherein said measurement tool further comprises a handle for controlling the length of said flexible stripe extending out of said tube by moving along a longitudinal axis of said measurement tool.
42. A system according to claim 33 , wherein said insertion tool further comprises a handle for controlling the grasping by moving along a longitudinal axis of said insertion tool.
43. A system according to claim 33 , wherein said grip head comprises at least two segments, said segments are for being departed from each other or for being brought closer to each other to modify the external diameter of said grip head.
44. A system according to claim 33 , wherein said delivery tool further comprises an adjustment head having a varying external diameter for adjusting the external diameter of said grip head by insertion or extraction of said adjustment head between segments of said grip head.
45. A system according to claim 33 , wherein the external diameter of said grip head is reducible to allow detaching of said tubular body from said grip head.
46. A system according to claim 33 , wherein said delivery tool further comprises a tube, wherein said grip head is insertible into said tube at least during passing of said delivery tool into a body lumen.
47. A system according to claim 33 , wherein said delivery tool further comprises control means on a handle of said delivery tool for controlling gripping and detaching of said tubular object.
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US13/909,199 US20140358212A1 (en) | 2007-06-19 | 2013-06-04 | Method and system for insertion of a graft |
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US13/909,199 Abandoned US20140358212A1 (en) | 2007-06-19 | 2013-06-04 | Method and system for insertion of a graft |
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Cited By (1)
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US20140358212A1 (en) * | 2007-06-19 | 2014-12-04 | Hdh Medical Ltd. | Method and system for insertion of a graft |
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---|---|---|---|---|
US6679888B2 (en) * | 2001-05-29 | 2004-01-20 | Synthes | Femur lever |
JP3849140B2 (en) * | 2002-10-30 | 2006-11-22 | ニプロ株式会社 | Blood vessel gripper |
WO2005074817A1 (en) * | 2004-02-09 | 2005-08-18 | Avastra Ltd | Instruments for sutureless surgical technique |
EP2005904A3 (en) * | 2007-06-19 | 2009-03-04 | HDH Medical Ltd. | System for insertion of a graft |
-
2008
- 2008-06-19 EP EP08158536A patent/EP2005904A3/en not_active Withdrawn
- 2008-06-19 US US12/142,025 patent/US20080319452A1/en not_active Abandoned
-
2013
- 2013-06-04 US US13/909,199 patent/US20140358212A1/en not_active Abandoned
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US4470415A (en) * | 1982-08-19 | 1984-09-11 | The Johns Hopkins University | Sutureless vascular anastomosis means and method |
US5290299A (en) * | 1991-12-11 | 1994-03-01 | Ventritex, Inc. | Double jaw apparatus for attaching implanted materials to body tissue |
US5735290A (en) * | 1993-02-22 | 1998-04-07 | Heartport, Inc. | Methods and systems for performing thoracoscopic coronary bypass and other procedures |
US5578031A (en) * | 1993-05-10 | 1996-11-26 | Wilk; Peter J. | Laparoscopic instrument assembly and associated method |
US6273895B1 (en) * | 1995-06-06 | 2001-08-14 | Corvita Corporation | Method of measuring a body cavity |
US6299642B1 (en) * | 1997-02-13 | 2001-10-09 | Kwan-Ho Chan | Bone cement plug for deployment in a bone canal |
US5762451A (en) * | 1997-02-26 | 1998-06-09 | Jennmar Corporation | Multi-piece, split bail expansion anchor |
US20050240205A1 (en) * | 1998-11-06 | 2005-10-27 | St. Jude Medical Atg, Inc. | Medical grafting methods and apparatus |
US6402757B1 (en) * | 1999-03-12 | 2002-06-11 | Biomet, Inc. | Cannulated fastener system for repair of bone fracture |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20140358212A1 (en) * | 2007-06-19 | 2014-12-04 | Hdh Medical Ltd. | Method and system for insertion of a graft |
Also Published As
Publication number | Publication date |
---|---|
EP2005904A2 (en) | 2008-12-24 |
US20140358212A1 (en) | 2014-12-04 |
EP2005904A3 (en) | 2009-03-04 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: HDH MEDICAL LTD., ISRAEL Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:WAYSBEYN, IGOR;KAVOUNOVSKI, IRINA;REEL/FRAME:022170/0510 Effective date: 20090119 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |